Implantable cardiac defibrillators in octogenarians
Maarten Pauwelyn1
Sebastian Ingelaere2
Ruben Hoffmann3
Johan Vijgen4
Georges H.Mairesse5
Ivan Blankoff6
Yves Vandekerckhove7
Jean-Benoit le Polain de Waroux7
Bert Vandenberk8
Rik Willems2
1.University Hospitals Leuven,Cardiology,Leuven,Belgium2.University Hospitals Leuven,Cardiology,Leuven,Belgium;KU Leuven,Department of Cardiovascular Sciences,Leuven,Belgium3.UZA,Department of Cardiology,Antwerp,Belgium4.Jessa Ziekenhuis,Department of Cardiology,Hasselt,Belgium5.Cliniques du Sud Luxembourg,Department of Cardiology,Arlon,Belgium6.CHU Charleroi,Department of Cardiology,Charleroi,Belgium7.AZ Sint-Jan,Department of Cardiology,Brugge,Belgium8.KU Leuven,Department of Cardiovascular Sciences,Leuven,Belgium;University of Calgary,Libin Cardiovascular Institute,Calgary,Canada
摘要：OBJECTIVE Implantable cardiac defibrillators (ICD) implantation in the very elderly remains controversial. We aimed to de-scribe the experience and outcome of patients over 80 years old implanted with an ICD in Belgium. METHODS Data were extracted from the national QERMID-ICD registry. All implantations performed in octogenarians between February 2010 and March 2019 were analysed. Data on baseline patient characteristics, type of prevention, device config-uration and all-cause mortality were available. To determine predictors of mortality, multivariable Cox proportional hazard re-gression modelling was performed. RESULTS Nationwide, 704 primo ICD implantations were performed in octogenarians (median age 82, IQR 81-83 years; 83％male and 45％ secondary prevention). During a mean follow-up of 3.1 ± 2.3 years, 249 (35％) patients died, of which 76 (11％) within the first year after implantation. In multivariable Cox regression analysis age (HR = 1.15, P = 0.004), oncological history (HR = 2.43, P = 0.027) and secondary prevention (HR = 2.23, P = 0.001) were independently associated with 1-year mortality. A better preserved left ventricular ejection fraction (LVEF) was associated with a better outcome (HR = 0.97, P = 0.002). Regarding overall mortality multivariable analysis withheld age, history of atrial fibrillation, centre volume and oncological history as signi-ficant predictors. Higher LVEF was again protective (HR = 0.99, P = 0.008). CONCLUSIONS Primary ICD implantation in octogenarians is not often performed in Belgium. Among this population, 11％died within the first year after ICD implantation. Advanced age, oncological history, secondary prevention and a lower LVEF were associated with an increased one-year mortality. Age, low LVEF, atrial fibrillation, centre volume and oncological history were indicative of higher overall mortality.
机标关键词：cardiacdefibrillatorsimplantableoctogenarians
论文发表日期：2023-01-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：9( 23-31 )